Trends in interdisciplinary referrals to and from chiropractors: CAM and mainstream providers

Objectives: Referral of patients among healthcare professionals improves the likelihood of appropriate care. Chiropractors are at the crossroads of mainstream medicine and complementary and alternative care (CAM). This presentation uses current and previous survey data to investigate the flow of patient referrals to and from chiropractors. Methods: Survey data from the Practice Analysis of Chiropractic 2010 by the National Board of Chiropractic Examiners (NBCE) was reviewed and provider types were categorized as CAM or mainstream medicine. The current data was compared to similar responses from previous NBCE survey reports in 2005 and 2000 to determine any significant trends. Results: Virtually all chiropractic practitioners make referrals to other healthcare providers (99.3%) and receive professional referrals (98.3%). The top two providers in both categories are massage therapists (CAM providers) and family practitioners (mainstream medicine). Respondents wrote in a wide variety of providers that were not on the list. Comparison with previous surveys was hampered by varying terminology, but indicated an increase over time in most categories, especially in the number of referrals made to chiropractors. Conclusions: Doctors of chiropractic receive many referrals of patients from both CAM and mainstream medical providers. They also refer their patients to both CAM and mainstream medical providers. The trend over the past ten years is for chiropractors to report more interdisciplinary sharing of patients, with both CAM and mainstream medicine.